TY - JOUR
T1 - Cytokines and the risk of preterm delivery in twin pregnancies
AU - Rode, Line
AU - Klein, Katharina
AU - Larsen, Helle
AU - Holmskov, Anni
AU - Andreasen, Kirsten Riis
AU - Uldbjerg, Niels
AU - Ramb, Jan
AU - Bødker, Birgit
AU - Skibsted, Lillian
AU - Sperling, Lene
AU - Hinterberger, Stefan
AU - Krebs, Lone
AU - Zingenberg, Helle
AU - Weiss, Eva-Christine
AU - Strobl, Isolde
AU - Laursen, Lone
AU - Christensen, Jeanette Tranberg
AU - Skogstrand, Kristin
AU - Hougaard, David Michael
AU - Krampl-Bettelheim, Elisabeth
AU - Rosthøj, Susanne
AU - Vogel, Ida
AU - Tabor, Ann
PY - 2012/7
Y1 - 2012/7
N2 - To estimate the association between cytokine levels in twin pregnancies and risk of spontaneous preterm delivery, including the effect of progesterone treatment. This secondary analysis of a randomized placebo-controlled trial investigating the effect of progesterone treatment on preterm delivery in twin pregnancies included 523 women with available dried blood spot samples collected before treatment with progesterone (n=258) or placebo (n=265) and after 4-8 weeks of treatment. Samples were analyzed for cytokines using a sandwich immunoassay. Cytokine levels in spontaneous preterm delivery at 34-37 weeks of gestation and spontaneous preterm delivery before 34 weeks of gestation were compared with delivery at 37 weeks of gestation or more for placebo-treated women. The association between interleukin (IL)-8 and risk of spontaneous preterm delivery before 34 weeks of gestation was estimated further, including comparison according to treatment. Statistical analyses included Kruskal-Wallis test, Mann-Whitney U test, linear regression, and Cox regression analysis. We found a statistically significant association between IL-8 and spontaneous preterm delivery. At 23-33 weeks of gestation, the median IL-8 level was 52 pg/mL (interquartile range 39-71, range 19-1,061) for term deliveries compared with 65 pg/mL (interquartile range 43-88, range 14-584) for spontaneous preterm delivery at 34-37 weeks of gestation and 75 pg/mL (interquartile range 57-102, range 22-1,715) for spontaneous preterm delivery before 34 weeks of gestation (P<.001). Risk of spontaneous preterm delivery was associated with a large weekly increase in IL-8 (hazard ratio 2.0, 95% confidence interval [CI] 1.2-3.3). There was no effect of progesterone treatment on IL-8 levels. Levels of IL-8 at 18-24 weeks of gestation were associated with a cervix less than 30 mm (odds ratio 1.8, 95% CI 1.2-2.7). Risk of spontaneous preterm delivery before 34 weeks of gestation is increased in women with high IL-8 levels. Progesterone treatment does not affect IL-8 levels. EudraCT, , 2006-000503-41, and ClinicalTrials.gov.
AB - To estimate the association between cytokine levels in twin pregnancies and risk of spontaneous preterm delivery, including the effect of progesterone treatment. This secondary analysis of a randomized placebo-controlled trial investigating the effect of progesterone treatment on preterm delivery in twin pregnancies included 523 women with available dried blood spot samples collected before treatment with progesterone (n=258) or placebo (n=265) and after 4-8 weeks of treatment. Samples were analyzed for cytokines using a sandwich immunoassay. Cytokine levels in spontaneous preterm delivery at 34-37 weeks of gestation and spontaneous preterm delivery before 34 weeks of gestation were compared with delivery at 37 weeks of gestation or more for placebo-treated women. The association between interleukin (IL)-8 and risk of spontaneous preterm delivery before 34 weeks of gestation was estimated further, including comparison according to treatment. Statistical analyses included Kruskal-Wallis test, Mann-Whitney U test, linear regression, and Cox regression analysis. We found a statistically significant association between IL-8 and spontaneous preterm delivery. At 23-33 weeks of gestation, the median IL-8 level was 52 pg/mL (interquartile range 39-71, range 19-1,061) for term deliveries compared with 65 pg/mL (interquartile range 43-88, range 14-584) for spontaneous preterm delivery at 34-37 weeks of gestation and 75 pg/mL (interquartile range 57-102, range 22-1,715) for spontaneous preterm delivery before 34 weeks of gestation (P<.001). Risk of spontaneous preterm delivery was associated with a large weekly increase in IL-8 (hazard ratio 2.0, 95% confidence interval [CI] 1.2-3.3). There was no effect of progesterone treatment on IL-8 levels. Levels of IL-8 at 18-24 weeks of gestation were associated with a cervix less than 30 mm (odds ratio 1.8, 95% CI 1.2-2.7). Risk of spontaneous preterm delivery before 34 weeks of gestation is increased in women with high IL-8 levels. Progesterone treatment does not affect IL-8 levels. EudraCT, , 2006-000503-41, and ClinicalTrials.gov.
KW - Adult
KW - Cytokines
KW - Dried Blood Spot Testing
KW - Female
KW - Humans
KW - Interleukin-8
KW - Pregnancy
KW - Pregnancy, Twin
KW - Premature Birth
KW - Progesterone
U2 - 10.1097/aog.0b013e31825bc3cd
DO - 10.1097/aog.0b013e31825bc3cd
M3 - Journal article
C2 - 22914392
SN - 1687-9589
VL - 120
SP - 60
EP - 68
JO - Obstetrics and Gynecology International
JF - Obstetrics and Gynecology International
IS - 1
ER -